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Topic: I'm Back - mtsarpilot (Read 2627 times)

11 years ago I shattered my Patella in a rock climbing fall, turning it into 5 pieces. ORIF was successful and some of the hardware was removed at 8 months, but could not get all the screws out due to bone growth.

I've had great care over the years, being an avid athlete (hi level tennis, downhill and backcountry skiing, rock and ice climbing, road and mountain biking, hiking, backpacking ... you get the idea) I've worn out the already bad knee. I've been bone-on-bone in the Patella / Femur arena for a couple years with reduced spacing medially due to meniscus damage from the initial injury and that which has been caused by the rough bones. So getting 11 years out of the remainder of this knee has exceeded expectations.

But ... the time has come, as much as I'd like to be in denial and hold it off longer, the knee is very limiting at this point and a TKR is the only option left. So November 8 will be the day.

One curiosity question for the forum. Here in the USA the standard of care is to replace the posterior portion of the Patella with a button that aligns well with the trochlea. But since I have screws in my Patella, they can't reasonably cut the posterior portion of the patella to resurface with the button. The screws are so deeply embedded at this point that they will do way to much damage trying to get them out. Thus the plan is to remove all the osteophytes from the Patella, but leave the posterior surface as it is. I understand this is the common practice in most countries except the USA. What has been peoples experience with non-resurfaced Patella in a TKR. Are folks indeed finding this works fine?

Are the other things I should be asking about or doing at this point? (I've started into PT to get the most ROM back I can before surgery, done tons of research on TKR in general and carefully selected the best / most experienced surgeon in the state, etc.). Any other suggestions from the gurus in the forum?

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9/05 - Patella fracture - 5 pieces in rock climbing fall, ORIF, 3 screws & figure 8 wire5/06 - HW Out7/06 - Back to full activity7/09 - Custom brace created to support knee during activity11/15 - Surgery to clean up meniscus, remove osteophytes, attempt to get more life out of knee11/16 - TKR

Hi Marilynjoy. I'm doing surprisingly well at this point. TKR on Nov. 8. Walking without without crutch or cane by day 10. Swelling has come down a little though the knee still looks like a grapefruit. No surprise so I hear. ROM at 5 - 110 now at day 15. Surprisingly low pain. A lot of ligament/tendon like popping inside the knee that I presume will subside once the swelling goes down for good.

A question I have for folks - Knee feels good when I wake up in the morning. After doing PT and working on ROM stretches, the darn thing seems to internally inflame (not visible externally) to the point that it feels like there is a band pulled tight on the back of my knee above the flexion point, and the front of the knee below the Patella. Ice does not help, only thing that reduces it is leg elevated above my body for an hour or so. But it comes back within 10 minutes of getting up to walk. Is this normal for this stage? Just a result of stretching and will stop happening once I stop working on ROM? Am I overdoing it on the PT? I'll ask the PT but that is not until Monday as everyone is gone for Thanksgiving.

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9/05 - Patella fracture - 5 pieces in rock climbing fall, ORIF, 3 screws & figure 8 wire5/06 - HW Out7/06 - Back to full activity7/09 - Custom brace created to support knee during activity11/15 - Surgery to clean up meniscus, remove osteophytes, attempt to get more life out of knee11/16 - TKR

Hello mtsarpilot-- I am curious about your progress. Hope it's going well. I tripped on a sidewalk in DC on vacation, fractured my kneecap and had an ORIF in October 2015. I spent many hours during recovery reading old posts of yours and many others. It was a godsend to read firsthand accounts and I want to thank you for all the info provided. I am pretty much recovered a year later- except for stairs and inclines which are a challenge. I'm very grateful to be where I am now. This site really kept me going when my spirit was low- I recovered ROM very slowly and it seemed like it would never happen! This forum was so educational and encouraging -- I'm sure it's done the same for so many others as well. So your posts from years ago are still doing good for the newly injured like me! Anyway I'm hoping your TKR is successful and brings you back to a high level of functioning soon. Best of luck-Kdarlene

Hi KDarlene - I'm glad all the posts many years ago continue to be helpful. It is a nasty injury, every little bit helps.

The TKR has been successful mechanically. I've got full range of motion and the knee moves well. Struggling with IT Band problems (tightness and inflammation) that limits how hard I can strengthen right now, though I'm only at 9 weeks. I'd like to be getting back to activities at the 12 week point but the IT Band is being such a bugger the knee may not be ready at that point. Some of this is likely due to the previous injury complications and some due to the bow-leg being straightened at part of the TKR. Overall I expect it will be happy in a few months.

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9/05 - Patella fracture - 5 pieces in rock climbing fall, ORIF, 3 screws & figure 8 wire5/06 - HW Out7/06 - Back to full activity7/09 - Custom brace created to support knee during activity11/15 - Surgery to clean up meniscus, remove osteophytes, attempt to get more life out of knee11/16 - TKR

Mtsarpilot--It's great to hear you are making good progress even though not as quickly as you'd like. But you have the important qualities of patience and perseverance so it will happen. There's no doubt! My husband is maintaining one knee with rooster comb injections but a TKR is in his future due to wear and tear- he is 63 but can still play golf and work out at the gym. He has a well respected OS ready to do the surgery when he becomes more restricted. Both knees actually appear to be bone on bone. After my ORIF a year ago due to a fall, I still need more strength and balance. I'm going to ramp up the exercises again and perhaps ask my doctor for a little more direction from a PT. I was released about 7 months ago and have progressed but I may need more direction at this point. I'm not happy with just being 'functional'- I'd like to resume all my previous activities!! Best of luck with that IT band and I'm glad your progress is going well--- Kdarlene